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MICKENBERGS AMBULATORY FOOT CARE PA
NPI 1386822104
Durable Medical Equipment & Medical Supplies in Pasadena, MD

Active since February 04, 2008
8094 EDWIN RAYNOR BLVD, STE C, PASADENA, MD 21122(410) 255-0040(410) 360-4955 Get Directions Write a Review

NPPES record last updated: April 14, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mickenbergs Ambulatory Foot Care Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICKENBERGS AMBULATORY FOOT CARE PA (NPI 1386822104) is a healthcare organization registered as a durable medical equipment & medical supplies in Pasadena, Maryland and active in the NPI registry since February 2008. The organization lists Jay Marc Mickenberg, Owner, as its authorized official.

NPPES Registry Identity

NPI1386822104
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameMICKENBERGS AMBULATORY FOOT CARE PA
Location Address8094 EDWIN RAYNOR BLVD, STE CPasadena, MD 21122-6834
Mailing Address8094 Edwin Raynor Blvd, Ste CPasadena, MD 21122-6834 · (410) 255-0040 · Fax (410) 360-4955
Phone(410) 255-0040
Fax(410) 360-4955
Organization SubpartNo
Authorized OfficialJay Marc MickenbergOwner · (410) 255-0040
Enumeration DateFebruary 4, 2008
Last NPPES UpdateApril 14, 2011
✔ NPI 1386822104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
License✔ Licensed in MD · 01053
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Also ListedPodiatristTaxonomy 213E00000X · License 01053 (MD)
8094 EDWIN RAYNOR BLVD, Pasadena, MD 21122
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Other Identifiers 19

Other1386822104Employer Health Insurance
OtherT765MD · Blue Choice
Other1338463Cigna
Other1386822104Coventry
Other1386822104Fidelity
Other217484Mdipa/optimum Choice
Other1386822104Ehp
Other1386822104Tricare
Other1386822104United Healthcare
Medicare NSC0728330001MD
OtherT276MD · Carefirst
Medicare UPINT93190
Medicaid062308307MD
Other1386822104First Health
Other1386822104Alliance
OtherB765 001Carefirst Federal Employee Program
Other1386822104Mamsi
Medicare PINT276MD
Other480012800Railroad Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mickenbergs Ambulatory Foot Care Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mickenbergs Ambulatory Foot Care PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jay Mickenberg, DPM
Podiatry
NPI 1336149962
8094 EDWIN RAYNOR BLVD SUITE C
Pasadena, MD 21122
(410) 255-0040
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mickenbergs Ambulatory Foot Care PA's NPI number?

The NPI number for Mickenbergs Ambulatory Foot Care PA is 1386822104. It was assigned to this organization in the NPPES registry on February 4, 2008.

Where is Mickenbergs Ambulatory Foot Care PA located?

Mickenbergs Ambulatory Foot Care PA is located at 8094 Edwin Raynor Blvd Ste C, Pasadena, MD 21122. The listed phone number is (410) 255-0040.

What is Mickenbergs Ambulatory Foot Care PA's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Is Mickenbergs Ambulatory Foot Care PA enrolled in Medicare?

Yes. Mickenbergs Ambulatory Foot Care PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mickenbergs Ambulatory Foot Care PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Mickenbergs Ambulatory Foot Care PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mickenbergs Ambulatory Foot Care PA was last updated on April 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.